Date of Award

Summer 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Program or Major

Direct Entry Master's in Nursing (DEMN)

Degree Name

Master of Science

First Advisor

Briana White DNP, RN, CNL

Second Advisor

Deborah Simonton EdD, RN, CNL

Third Advisor

Pamela Kallmerten PHD, DNP, RN, CNL

Abstract

Abstract

Background: Symptoms of severe mental illnesses can result in Personal Safety Emergencies (PSE’s) in the acute in-patient psychiatric setting. As part of treatment of PSE’s, restrictive interventions such as seclusion are utilized in current practice to maintain the safety of the patient, peers, staff, and the environment. Evidence-based research has shown restrictive interventions can cause physical and psychological harm to both patients and staff. Reducing restrictive interventions continues to be a priority to create the most therapeutic environment possible. Evidence-based research has shown that sensory modulation is a non-restrictive intervention that can reduce the use of restrictive interventions, decrease workplace violence, decrease patient distress and anxiety, and improve patient and staff relations.

Methods: The Plan-Do-Study-Act (PDSA) model for Quality Improvement (QI) was utilized. Data from pre-training and post-training surveys completed by training attendees, the hospital’s internal PSE and restrictive interventions report trend data, and unit and staff rounding thematic data was collected and analyzed.

Intervention: The project lead, in collaboration with hospital subject matter experts and key stakeholders, developed and presented in-person and online educational training to staff on sensory modulation to reduce PSE’s and patient time in seclusion.

Results: Correct responses for all participants for all knowledge-based questions improved after the training in comparison to before the training. Reported confidence levels by all participants in presenting sensory modulation interventions to patients improved after the training in comparison to before the training. There was a 67% decrease in the unit’s number of PSEs from the one week prior to the training to the two weeks after the training. There was an 86.7% decrease in the unit’s patient seclusion minutes from the one week prior to the training to the two weeks after the training.

Conclusion: The implementation of this QI project increased the knowledge of sensory modulation and confidence to integrate it into patient therapeutic options by direct patient care staff. This project supported that sensory modulation is an achievable and effective intervention to reduce personal safety emergencies and the use of seclusion. Sensory modulation education and techniques should be integrated hospital-wide. Additional QI and research should be conducted to continue to gather evidence on the beneficial and therapeutic effects of sensory modulation in the acute in-patient psychiatric setting.

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